DESCRIPTION: During the last three years, this project has: (1) conducted a series of multi-center studies evaluating pain and its treatment, both with non-minority and minority cancer patients, and determined risk factors for those patients indexed as having poor pain management, (2) developed a sequence of clinical trials of interventions to change both health care professional and patient behavior regarding pain and its management, based on a model of analgesic practice change, (3) refined our understanding of pain assessment measures and the relationship between pain severity and the impact of pain on the patient, especially the relationship between culture and language on pain report, and (4) demonstrated the utility of collaborative international studies of pain and pain treatment for assessing and treating U.S. cancer patients and for understanding factors that lead to poor pain management. The research goals of this funding period will focus on methods to reduce the number of patients who continue to receive inadequate pain control. These studies will: (1) implement both descriptive and intervention studies in multi-center studies performed in NCI-sponsored collaborative groups, (2) continue international studies of cancer pain, its assessment and its treatment and test methods of modifying health care practice of cancer pain management, and (3) incorporate medical decision making methodology to establish new ways of evaluating the effectiveness of pain and symptom control therapies. The studies described will make use of established collaborations with international pain and oncologic investigators, and the Eastern Cooperative Oncology Group, and develop new collaborations with the UTMD Anderson NCI-funded research base and the Radiation Treatment Oncology Group.